Σύγκριση της ανοιχτής προστατεκτομής και της PVP-Greenlight λέιζερ προστατεκτομής σε ασθενείς που πάσχουν από καλοήθη υπερπλασία του προστάτη, με αδενώματα μεγαλύτερα των 80 κυβικών εκατοστών ; Transvesical open enucleation of the prostate versus PVP-Greenlight laser prostatectomy for prostatic adenomas > 80cc

ObjectivesTo compare the effectiveness and the safety of photoselective vaporization of the prostate (PVP) to open prostatectomy (OP) for the surgical treatment of large prostatic adenomas.MethodsA total of 125 patients with prostate glands >80ml were randomly allocated to PVP (n=65) or OP (n=60) and prospectively evaluated at 1, 3, 6, and 12 mo postoperatively. International Prostate Symptom Score (IPSS) and peak urinary flow rate (Qmax) were chosen as primary treatment-related end points.ResultsThe patients who underwent PVP experienced a longer length of operation time, shorter time of catheterization, and shorter hospital stay. Adverse events were minor and of similar profiles in both groups, although patients who underwent OP showed a higher transfusion rate. All functional parameters improved significantly compared to baseline values in both groups. The IPSS did not differ between the two groups at 3, 6, and 12 mo postoperatively. Patients who underwent OP scored better in the IPSS quality of life score at 6 and 12 mo postoperatively. No significant differences between the two groups in the Qmax, postvoid residual urine volume, and International Index for Erectile Function-5 questionnaire were detected. At 3 mo prostate volume was significantly lower in the OP group compared to the PVP group (median value 10ml vs. 50ml; p<0.001) and remained as such throughout follow-up, whereas prostate-specific antigen values reached statistical difference at 6 mo (median value 2ng/ml vs. 2.4ng/ml; p=0.028).ConclusionsOur results indicate that for a 12-mo period PVP is a highly acceptable treatment alternative to OP. ; ΣΚΟΠΟΣ. Σύγκριση της ασφάλειας και της αποτελεσματικότητας της PVP-Greenlight λέιζερ προστατεκτομής με την ανοιχτή προστατεκτομή για την χειρουργική αντιμετώπιση μεγάλων προστατικών αδενωμάτων. ΜΕΘΟΔΟΣ. 125 ασθενείς με προστατικά αδενώματα >80γρ τυχαιοποιήθηκαν σε 2 ομάδες PVP(65) ανοιχτή προστατεκτομή (60) και μελετήθηκαν προοπτικά στους 1,3,6,12 μήνες. Ως πρωταρχικοί στόχοι της μελέτης ...